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Intradermal anaesthesia: comparison of several compounds   总被引:1,自引:0,他引:1  
Objective: To compare the efficacy of different local anaesthetics to produce intradermal anaesthesia for venous cannulation and the discomfort associated with skin infiltration.
Measurements: A visual analog scale (VAS) for pain (0 = no pain/10 = most pain imaginable) was used to assess pain elicited by raising the skin wheal and inserting the cannula.
Main results: With regard to analgesic potency all five local anaesthetics were comparable (mean VAS–score 1.7–2.09) and effective when compared to 0.9% saline (mean VAS–score 4.2; P < 0.001). Infiltration pain was least with mepivacaine–1 (mean VAS–score 1.0; P < 0.001) and highest with procaine (mean VAS score 2.7; P < 0.001).  相似文献   

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One hundred and six former or current flexible trainees in anaesthesia responded to a questionnaire evaluating their part-time training (a response rate of 71%). They were compared with a group of 32 flexible trainees in obstetrics and gynaecology. Anaesthetists were more satisfied than obstetricians and gynaecologists with their training (96% compared with 84%); opportunities to publish (75% and 63%); research training (63% and 48%); and monitoring of their progress (78% and 67%). Without flexible training, 20% of the anaesthetists would have ceased to train, compared with 9% of the obstetrics and gynaecology group. Nearly all those who had finished their training were working as consultants (54% of the whole group); 4% had either retired, become a clinical assistant or a locum consultant. The remainder (42%) were senior registrars.   相似文献   

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The standard spinal preparation of bupivacaine contains a highconcentration of glucose (80 mg ml–1). However,the addition of only a small amount of glucose (8 mg ml–1)to plain solutions of bupivacaine results in a solution which,although no more than marginally hyperbaric, produces a morepredictable block when used for spinal anaesthesia in non-pregnantpatients. However, bupivacaine 5 mg ml–1 inglucose 8 mg ml–1 has a density [1.00164 (SD0.00008) at 37°C] which is relatively greater than thatof the cerebrospinal fluid (CSF) of the pregnant patient atterm (1.0003 at 37°C) because CSF density decreases duringpregnancy. Therefore, a double-blind, randomized, controlledstudy was carried out to compare intrathecal bupivacaine (glucose8 mg ml–1) with bupivacaine (glucose 80 mg ml–1)in 40 pregnant patients at term. Although there was no differencebetween groups in onset of sensory block, dose of ephedrineor patient satisfaction, patients receiving bupivacaine (5 mg ml–1)with glucose (8 mg ml–1) had persistently highersensory blocks between 60 and 120 min after intrathecalinjection, suggesting that the spread of spinal solutions inthe pregnant patient at term is not dependent on density. Br J Anaesth 2001; 86: 805–7  相似文献   

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Background. Hyperbaric solutions of ropivacaine have been usedsuccessfully to provide spinal anaesthesia. This study was designedto compare the clinical efficacy of hyperbaric ropivacaine withthat of the commercially available hyperbaric preparation ofbupivacaine. Methods. Forty ASA grade I–II patients undergoing lower-abdominal,perineal or lower-limb surgery under spinal anaesthesia wererecruited and randomized to receive ropivacaine 5 mg ml–1(with glucose 50 mg ml–1), 3 ml or bupivacaine 5 mg ml–1(with glucose 80 mg ml–1), 3 ml. The level and durationof sensory block, intensity and duration of motor block, andtime to mobilize and micturate were recorded. Patients wereinterviewed at 24 h and at 1 week to identify any residual problems. Results. All blocks were adequate for the proposed surgery,but there were significant differences between the two groupsin mean time to onset of sensory block at T10 (ropivacaine 5min; bupivacaine 2 min; P<0.005), median maximum extent (ropivacaineT7; bupivacaine T5; P<0.005) and mean duration of sensoryblock at T10 (ropivacaine 56.5 min; bupivacaine 118 min; P=0.001).Patients receiving ropivacaine mobilized sooner (ropivacainemean 253.5 min; bupivacaine 331 min; P=0.002) and passed urinesooner (ropivacaine mean 276 min; bupivacaine 340.5 min; P=0.01)than those receiving bupivacaine. More patients in the bupivacainegroup required treatment for hypotension (>30% decrease insystolic pressure; P=0.001). Conclusions. Ropivacaine 15 mg in glucose 50 mg ml–1 providesreliable spinal anaesthesia of shorter duration and with lesshypotension than bupivacaine. The recovery profile for ropivacainemay be of interest given that more surgery is being performedin the day-case setting. Br J Anaesth 2003; 90: 304–8  相似文献   

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Arterial oxygenation during one-lung anaesthesia (1)   总被引:2,自引:0,他引:2  
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Br J Anaesth 2001; 86: 709–16  相似文献   

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Arterial oxygenation during one-lung anaesthesia (2)   总被引:1,自引:0,他引:1  
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